目的：探讨小儿体外循环(CPB)围术期血清细胞间粘附分子-1(ICAM-1)水平变化规律和升高原因及测定的临床意义。方法：采用双抗夹心法酶联吸附试验(ELISA)法分别于手术前、转流后30 min、手术毕、术后2 h、12 h、24 h、48 h共7个时点测定33例先天性心脏病(CHD)患儿；分别于术前，术中及术后2 h测定10例非体外循环普胸手术患儿及30例健康体检患儿ICAM-1水平。结果：CHD术前ICAM-1无变化；CPB术后ICAM-1水平较非CPB明显升高，P<0.005；血清ICAM-1值于CPB 30 min后开始上升，至24 h达到高峰后开始下降，48 h尚未降至术前水平；CPB时间≥90 min组ICAM-1显著升高，P<0.05。结论：小儿CPB心脏直视手术后血清ICAM-1升高明显，CPB时间是ICAM-1升高的主要原因，ICAM-1测定对预防及早期发现并发症有一定的临床意义。
To evaluate the role of serum intercellular adhesion molecule (ICAM-1)changes during pediatric cardiopulmonary bypass (CPB) surgery for congenital heart diseases (CHD)and the clinic significance of monitoring the serum ICAM-1 level. Methods: ICAM-1 levels were measured by double antibodies sandwich ELISA in arterial specimen from 33 CPB cases at various time points,the results were compared with those of 10 non-CPB patients and 30 normal children. Results:Patients with CHD had normal levels of serum ICAM-1 before surgery. The serum ICAM-1 levels in CPB group were significantly higher than those of controls (P〈0. 005). ICAM-1 levels started increasing as early as 30 minutes of CPB began and peaked 24 hours after surgery and stayed up 48 hours after surgery . The serum ICAM-1 levels in patients whose CPB lasted longer than 90 minuets were significantly higher (P<0.05). Conclusion:ICAM-1 showed higher and lasted longer after pediatric CPB surgery. The length of CPB is associated with elevation of ICAM-1. Monitoring of serumICAM-1 ,in certain degree,may help in predicting prognosis and complication after CPB surgery.
李建华;张泽伟;陈黎勤. 小儿体外循环手术围术期细胞间粘附分子-1的测定[J]. 浙江大学学报（医学版）, 2000, 29(2): 63-66.